INCLUSION OF HIGH INTENSITY INTERVAL TRAINING IN CARDIOVASCULAR REHABILITATION AFTER STROKE: A RANDOMIZED CONTROL TRIAL

Abstract

<h3>BACKGROUND</h3> Standard exercise prescriptions recommend moderate intensity continuous training (MICT) for stroke patients. High intensity interval training (HIIT) has emerged as a potentially effective method for increasing cardiorespiratory fitness (CRF) among clinical populations, but its effectiveness remains to be demonstrated after stroke. This study aimed to compare the effect of a 6-month exercise program with either MICT or a combination of HIIT and MICT and a control group in terms of CRF, cardiovascular risk factors, functionality, cognitive function, anxiety and depression markers with a 12-month follow-up in patients with prior ischemic stroke or transient ischemic attack (TIA). <h3>METHODS AND RESULTS</h3> This randomized controlled trial included 52 participants (mean age: 69.2 ± 10.7) divided into 3 groups: HIIT, MICT and control. Forty participants completed the 12-month follow-up. CRF and secondary outcomes were assessed at baseline after the 6-month intervention and at a 12-month follow-up. A significant interaction effect (p < 0.001) indicate that HIIT and MICT programs provide a similar increase of CRF as compared to the control group. Despite a slight decrease at the 12-month follow-up, this improvement persists 6 months post-exercise (p < 0.01). The two exercise programs also induced a comparable increase in self-reported physical activity and cognitive function as well as a decrease in anxiety and depression markers. Participants in both the HIIT and MICT programs declared a very good degree of acceptability. <h3>CONCLUSION</h3> This randomized control trial demonstrated that a 6-month combination of HIIT and MICT program or a standard MICT exercise program induced a similar improvement in CRF, self-reported physical activity, cognitive functions and anxiety and depression markers among patients prior ischemic stroke or TIA compared to with a control group, suggesting that a combination of HIIT and MICT may be an effective alternative to standard exercise recommendations.